Individual provider · Type 1 NPI

Carlos Mikkel Wynn, OTR/L

Occupational Therapist · Lawrenceville, GA

NPI number 1124485602 Active

Practice location

545 Old Norcross Rd, Suite 100
Lawrenceville, GA 30046-3389

Call (678) 377-2833 Map

Fax (678) 377-2882

Mailing address

1550 Cornell Ct
Statham, GA 30666-2046

Specialties and licenses

TaxonomyCodeLicense
Occupational Therapist Primary 225X00000XOT006330 (GA)

Occupational Therapist: An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork…

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About NPI 1124485602

Carlos Mikkel Wynn, OTR/L's National Provider Identifier is 1124485602, issued on Jan 28, 2016. The primary taxonomy on file is Occupational Therapist (225X00000X), and the practice location is in Lawrenceville, GA. The record was last updated on Jan 28, 2016.